Claims Representative II - Inside

Employer
Tower Hill Insurance Group
Location
Gainesville, Florida
Salary
Not Specified
Posted
Jun 05, 2019
Closes
Jul 20, 2019
Ref
6384809#GIJtoGJS.1
Industry
Insurance
Category
Insurance

Tower Hill Insurance Group has an exciting opportunity for a talented Claims Representative II - Inside who enjoys intellectual challenge and seeks a rewarding career with a company that is experiencing growth.

Review and analyze routine first party homeowner’s claims to determine extent of insurance carrier’s liability, determines the extent of damaged property, and recommends settlement amounts in order conclude claims with policyholders in accordance with policy provisions and applicable insurance statutes and laws.

These claims are more complex in nature and involve moderate to severe structural damage.  Investigations are more involved, often relying on consultant, expert opinion and/or use of specialized tradesman to assist with coverage and damage determinations. Claims involve multiple parties (attorneys, public adjusters, contractors) and generally have longer life cycles.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

Reviews the insurance policy, endorsements, and related information in order to make a coverage determination.

(INVESTIGATION)

  • Conducts the appropriate claim investigation and directs the investigation of any assigned resources.
  • Obtains any physical evidence, develops third party information and theory of liability, conducts recorded interviews, and secures official records.
  • Recognizes and submits subrogation, underwriting and SIU referrals as necessary.
  • Maintains file documentation, file notes and investigation documentation on each assigned claim in accordance with company guidelines.

 (DECISION MAKING)

  • Reviews policy, adjusters’ reports, damage estimates, expert reports and any other documentation needed to make the appropriate coverage and loss decisions to conclude assigned claims.
  • Able to write/create/edit estimates based on customer’s information or independent adjuster’s information utilizing computerized estimating system.
  • Able to write/create/edit letter to confirm status or decision.
  • Makes recommendations and decisions based on claim documentation and investigation.

 (COMMUNICATION)

  • Provides prompt service to policyholders utilizing phone, fax, mail and electronic mail. Communicates with all customers in a professional manner.
  • Complies with customer service objectives (as determined by the company)
  • Communicates with Claims Supervisors consistent with company guidelines.

(LICENSURE)

  • Successfully completes training and maintains FL License by meeting Continuing Education requirements.
  • Operates in accordance with Florida Statues

OTHER RESPONSIBILITIES

  • Provide support to other members of the technical claims staff.
  • Participates in CAT Duty as required.
  • Other duties as determined by management

 EDUCATION and/or EXPERIENCE

College degree (four-year college/university) or equivalent professional education and experience combined; Minimum of 4 - 7 years related adjusting experience and successful completion of more advanced level claims training courses and/or insurance industry courses as identified in Claims Training Manual (i.e. Insurance principles, loss adjustment, estimating software, and residential construction).  Completion of advanced job training.

SUCCESSFUL CANDIDATES ARE EXPECTED TO:

  • Contribute to team discussions
  • Become proficient with all tools and technologies
  • Be open with new ideas or proposals
  • Possess strong communication skills
  • Adaptable to change
  • Excellent customer focus

 TOWER HILL’S TOTAL COMPENSATION PACKAGE INCLUDES:

  • Competitive starting salary
  • Annual merit reviews and bonus potential
  • Medical, Dental, Life and Disability Insurance, and Health Savings Accounts
  • Matching 401(k) Plan
  • Paid PTO and holidays
  • Learning & Development Opportunities
  • Tuition Reimbursement
  • State of the Art work out facility (Corporate office)
  • Business casual dress, and more 

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